Must skin cancer moderate dysplastic nevus be removed?

The management of moderate dysplastic nevi (MDN) depends on various factors such as the patient's age, the number of MDN, their clinical and dermoscopic features, the patient's personal and family history of melanoma, and the expertise and preference of the treating physician. However, there is no universal consensus on the exact criteria for removal. Here are some general guidelines:

1. Clinical and Dermoscopic Evaluation:

MDN are typically characterized by certain clinical and dermoscopic features that may indicate a higher risk of progression to melanoma. These features include asymmetry, irregular borders, color variegation, and specific dermoscopic patterns. A thorough evaluation by a dermatologist or a healthcare professional experienced in skin cancer diagnosis is essential to assess the risk associated with each MDN.

2. Multiple MDN:

The presence of multiple MDN (usually defined as more than 5-10) may warrant closer monitoring or consideration for removal. Multiple MDN can be an indicator of an increased overall risk of melanoma.

3. Atypical Features:

Certain atypical features within an MDN, such as marked architectural disorganization, severe pleomorphism, or specific vascular patterns, may raise concern for a higher risk of progression. These atypical features may prompt a recommendation for removal to reduce the potential risk.

4. Patient's Age:

Younger individuals may have a higher risk of melanoma developing from MDN compared to older individuals. Therefore, MDN in younger patients might be managed more conservatively, with close monitoring and removal considered only if there are concerning changes.

5. Personal and Family History of Melanoma:

A personal or family history of melanoma can influence the decision-making process. Patients with a history of melanoma or a strong family history may benefit from a more cautious approach, and MDN with concerning features might be considered for removal.

6. Patient Preferences and Concerns:

Ultimately, the patient's preferences and concerns should be taken into account. Some individuals may opt for removal of MDN for peace of mind, even if the medical risk is relatively low.

It's important to note that not all MDN require immediate removal. Close monitoring with regular follow-up examinations can be an appropriate strategy in some cases, especially for MDN with less concerning features. If there are any changes or new suspicious findings during monitoring, removal might be recommended.

Overall, the decision to remove a moderate dysplastic nevus is individualized and should be made in consultation with a qualified medical professional who has experience in the diagnosis and management of skin cancer.